Online digital recovery support services: An overview of the science and their potential to help individuals with substance use disorder during COVID-19 and beyond.
Online digital recovery support services: An overview of the science and their potential to help individuals with substance use disorder during COVID-19 and beyond.
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DOI：
10.1016/j.jsat.2020.108152
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发表时间：
2021-01
影响因子：
3.9
通讯作者：
Kelly JF
中科院分区：
文献类型：
--
作者：
Bergman BG;Kelly JF
COVID-19 大流行和相关的社交距离公共卫生建议将对当前和已缓解的药物使用障碍 (SUD) 患者产生间接影响。压力源不仅会增加症状恶化和/或复发的风险，而且在这一关键时期个人获得的服务也会受到限制。 SUD 患者正在使用免费的在线数字康复支持服务 (D-RSS)，该服务利用点对点连接（即社交在线 D-RSS），同时帮助这些人获得支持并遵守公共卫生指南。然而，SUD 治疗和康复支持服务的障碍并非 COVID-19 时代所独有。这场大流行病创造了一个机会，让人们认识到在其直接影响之外仍将持续存在的问题，并提供可能有助于解决这些长期存在的系统性问题的潜在解决方案。为了帮助提供者和其他主要利益相关者有效地支持那些对参与免费社交在线 D-RSS 感兴趣或可能从中受益的人，本次审查概述了以下内容：1）参与社交在线 D-RSS 的预期治疗益处和潜在缺点的理论； 2) 可用于描述和分类 D-RSS 的类型学； 3) 一个 D-RSS“案例研究”来说明如何应用理论和类型学； 4) 对社交在线 D-RSS 的经验了解是什么； 5) 是否以及如何让个人参与这些在线资源。叙述性评论结合了面对面康复支持和社交在线 D-RSS 的研究和理论。研究考察了 AA 和其他互助组织等面对面康复支持服务，并结合社交在线 D-RSS 如何带来益处的理论，表明这些数字支持可能会吸引 SUD 患者，并以类似的方式推动有益的改变。虽然人们可能同时使用面对面和数字支持，但在比较这两种方式时，通信科学和远程医疗团体治疗数据表明，D-RSS 可能无法提供与面对面服务相同程度的益处。 D-RSS 可以根据 a) 服务类型、b) 平台类型、c) 访问点和 d) 负责交付的组织进行分类。研究尚未专门严格测试社交在线 D-RSS 的有效性，尽管现有数据表明使用这些服务的人普遍认为他们的参与是有帮助的。内容分析表明，这些服务可能会促进社会支持，并且不太可能使个人面临有害的情况。当面对面的治疗和康复支持服务有限时，就像在 COVID-19 大流行期间的情况一样，预期的治疗效果和新出现的数据综合起来，建议提供者、导师和其他社区领袖可能希望将当前患有和已缓解 SUD 的个人转介到免费的社交在线 D-RSS。鉴于缺乏最佳实践指南的情况下存在大量可用服务，我们建议利益相关者在进行 D-RSS 推荐时，熟悉参与的理论优点和缺点，使用类型学来描述和分类服务，并整合当前的经验知识，同时依赖可信的联邦、学术和国家实践组织资源列表。
The COVID-19 pandemic and related social distancing public health recommendations will have indirect consequences for individuals with current and remitted substance use disorder (SUD). Not only will stressors increase risk for symptom exacerbation and/or relapse, but individuals will also have limited service access during this critical time. Individuals with SUD are using free, online digital recovery support services (D-RSS) that leverage peer-to-peer connection (i.e., social-online D-RSS) which simultaneously help these individuals to access support and adhere to public health guidelines. Barriers to SUD treatment and recovery support service access, however, are not unique to the COVID-19 epoch. The pandemic creates an opportunity to highlight problems that will persist beyond its immediate effects, and to offer potential solutions that might help address these long-standing, systemic issues. To help providers and other key stakeholders effectively support those interested in, or who might benefit from, participation in free, social-online D-RSS, this review outlines the following: 1) theories of expected therapeutic benefits from, and potential drawbacks of social-online D-RSS participation; 2) a typology that can be used to describe and classify D-RSS; 3) a D-RSS “case study” to illustrate how to apply the theory and typology; 4) what is known empirically about social-online D-RSS; and 5) whether and how to engage individuals with these online resources. Narrative review combining research and theory on both in-person recovery supports and social-online D-RSS. Studies examining in-person recovery support services, such as AA and other mutual-help organizations, combined with theory about how social-online D-RSS might confer benefit, suggest these digital supports may engage individuals with SUD and mobilize salutary change in similar ways. While people may use in-person and digital supports simultaneously, when comparing the two modalities, communication science and telemedicine group therapy data suggest that D-RSS may not provide the same magnitude of benefit as in-person services. D-RSS can be classified based on the a) type of service, b) type of platform, c) points of access, and d) organizations responsible for their delivery. Research has not yet rigorously tested the effectiveness of social-online D-RSS specifically, though existing data suggest that those who use these services generally find their participation to be helpful. Content analyses suggest that these services are likely to facilitate social support and unlikely to expose individuals to harmful situations. When in-person treatment and recovery support services are limited, as is the case during the COVID-19 pandemic, expected therapeutic benefits and emerging data, taken together, suggest providers, mentors, and other community leaders may wish to refer individuals with current and remitted SUD to free, social-online D-RSS. Given the array of available services in the absence of best practice guidelines, we recommend that when making D-RSS referrals, stakeholders familiarize themselves with theorized benefits and drawbacks of participation, use a typology to describe and classify services, and integrate current empirical knowledge, while relying on trusted federal, academic, and national practice organization resource lists.
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